It’s bad enough that colleges and universities are facing the threat of temporary closures, cancellation of summer school, and loss of accreditation. But coupled with the bad news on higher education is an equally grim outlook for health care.

A sample of the legacy left us by Jindal’s hospital privatizations and closures:

In Baton Rouge, the closure of Earl K. Long (EKL) Medical Center had a ripple effect on the low income residents of North Baton Rouge. The emergency room patient care shifted onto Baton Rouge General Regional Medical Center Mid-City became such a money loser that it closed its emergency room on March 31, 2015. That moved emergency room care 30 minutes further away to Our Lady of the Lake (OLOL) Medical Center, located in largely white South Baton Rouge. One emergency room doctor confided to the author that it was his feeling that Jindal wanted to create “a medical wasteland north of Government Street.” Government Street, which traverses Baton Rouge in an east-west direction is a roughly-defined dividing line between South and North Baton Rouge.

Mid-City was hemorrhaging $2 million a month through its emergency room because Jindal refused to expand Medicaid and rejected any idea of putting up state money to keep the facility open. With the closure of its emergency room, residents of North Baton Rouge, which is largely low-income black in its demographic makeup, had few medical choices. With Our Lady of the Lake so far away, the alternatives were two urgent care clinics operated by the partnership of LSU and Our Lady of the Lake. The clinics were located on North Foster Street and Airline Highway. The North Foster clinic has no onsite doctor and the main Airline High clinic has a doctor onsite only until 7:00 p.m.

The same emergency room doctor who related the “medical wasteland” story told of the tragic case of an elderly African-American couple. “I felt sick reading this report,” he said. He said it involved “an old black couple who were paying $40 per month on their existing medical bill” to another Baton Rouge hospital.

The report read said the decedent was found “supine on bedroom floor. His wife told EMT personnel that her husband had congestive heart failure and that fluid had been building up. He did not go to the emergency room because the couple owed money to the hospital. She said he had been short of breath through the night and when she awoke, he was not breathing. CPR and advanced cardiac life support were initiated but were terminated after no response. “If he had gone to the LSU urgent care center, likely as not, no doctor would have been on duty,” the ER doctor said.

The closure of EKL and the decision by Baton Rouge General Mid-City to close its ER necessarily imposed a heavier workload on OLOL which entered into a partnership with the state for treatment of Medicaid patients. That increased workload has understandably also produced greater pressure on doctors and staff which in turn has apparently led to lapses in quality of care.

Consider the following brief email thread:

“Please see the email below sent from one of vascular consultants to our Associate Chief Medical Officer Dr. (redacted). My purpose for forwarding this email to you is not to criticize anyone nor is (it) to elicit a string of email responses. The sole purpose is to make all of us aware of the perception some of our consultants and primary care teams have of us. Increasingly of late, I am getting this type of feedback, be it real or otherwise.

“Doctors, we must elevate our game to meet the expectations of all our physician colleagues. I know you guys are working hard, but I am asking each of you to pay attention to the finer details.

“As Dr. (redacted) aptly said to me last night, our physician colleagues are our customers; we need to put ourselves in their shoes, be their voice, the voice of our customer.

Dr. (redacted)”

The email to which he referred read:

“I had a very irritating call last night from the ER. It bothers me that the environment around our hospital is deteriorating into a stereotypical dysfunctional training facility that we are all too familiar with and probably chose to go into private practice to avoid.

“I received a call at about 11:30 p.m. The answering service informed me who the call was about. When I called back a resident picked up and started telling me about ‘an endostent that had an endoleak with pain, transferred from Lake Charles.’ Knowing I was on city call, I figured I’d investigate this to expedite patient care. The resident told me they had already spoken to a doctor but it didn’t make sense when I couldn’t get the specifics I was asking for. At that point, I asked to speak to the attending whom (sic) was able to figure out they got the wrong guy. However, it’s a little disheartening that he didn’t readily know who the surgeon was they had spoken to that was assuming responsibility for the patient. He did mention ‘Dr. (redacted)” who is our resident (redacted)—but I’m not sure he knew it was a resident. It’s my feeling that in a patient potentially critical as this one—the attending should have his finger on the pulse a litter better than it appeared last night.

“After those 15 minutes I again informed the attending I was Dr. (redacted)…returning a page. At this point the attending gave me to ‘Dr (redacted), first year (emergency room) resident.’ The resident reports a consult on a patient with WBC (white blood cell) 19, blisters on cellulitic foot…When I ask asking info, it turns out the patient ‘has been on the board over 7 hours.’ When I ask to speak to attending who saw the patient—no longer working. At this point, I’m given back to the same attending who gave me to the first year resident he was covering. This attending was covering the resident, had taken sign-out, and expected the resident to call me and report but had never seen the patient. This reminds me of something I would get from the old ER at Mid-City, not what I would have received from OLOL in first 12 years of practice.

“I do realize we are a training facility but you and I both recognize that happens to a private practice service when run by residents. I’m sure the ER has exploded with new personal (sic) during this growth phase, but part of their responsibility is to know who the doctors are that routinely admit to this facility. To say the least, I was discouraged at the attending’s ‘finger on the pulse’ of what he was responsible for last night.

“This email is not to condemn any individual but to raise flags over the environment. Please forward to the appropriate people.”

(Sender’s name redacted)

Such is life in the aftermath of Bobby Jindal’s grand state hospital privatization scheme.

After reading this and knowing that these are not isolated occurrences, I want to know if any of those elected officials that are returning to the Legislature have read such as this? As I have said before, Jindal didn’t do this all by himself. My question, I guess, is, “How much longer are we going to put up with this? They vote destruction upon us, get re-elected and then act as if raising taxes will kill them. It is depressing. Thank you for posting the truth.

Jindal and most legislators are guilty of malfeasance and could be prosecuted if anyone had the courage to do it. I believe that would be the East Baton Rouge Parish District Attorney. It shouldn’t be too difficult to put together the case.

A. Malfeasance in office is committed when any public officer or public employee shall:

(1) Intentionally refuse or fail to perform any duty lawfully required of him, as such officer or employee; or

(2) Intentionally perform any such duty in an unlawful manner; or

(3) Knowingly permit any other public officer or public employee, under his authority, to intentionally refuse or fail to perform any duty lawfully required of him, or to perform any such duty in an unlawful manner.

B. Any duty lawfully required of a public officer or public employee when delegated by him to a public officer or public employee shall be deemed to be a lawful duty of such public officer or employee. The delegation of such lawful duty shall not relieve the public officer or employee of his lawful duty.

C.(1) Whoever commits the crime of malfeasance in office shall be imprisoned for not more than five years with or without hard labor or shall be fined not more than five thousand dollars, or both.

(2) In addition to the penalty provided for in Paragraph (1) of this Subsection, a person convicted of the provisions of this Section may be ordered to pay restitution to the state if the state suffered a loss as a result of the offense. Restitution shall include the payment of legal interest at the rate provided in R.S. 13:4202.

Part of the problem is that the previous administration drove out so many good public servants. Maybe the gov should see if he can get Fred Cerise back from Texas to head up our public healthcare system?

Jethro, why would Fred want to come back here. To go thru all of this again when another no noting repub gets elected. Our loss has been Texas’ gain, I promise u. Fred is top notch. Opelka on his best day can’t come close.

It’s not like they don’t have nuts in charge of Texas, Jerry. Now the students and faculty are going to be packing guns at the universities. But you’re probably right. Even the best people eventually just have to give up, leave Louisiana, and never return.

My letter, which is below, was published in the New Orleans Advocate on Oct. 19, 2012, which was 3 years and 4 months ago.
Most of these predictions about Jindal have come true. Unfortunately, the plea to the legislature reaped no response.
Joseph Biundo

Letter: Jindal hurting state health care
October 19, 2012

15 Comments
I voted for Bobby Jindal three times, contributed to his campaign and was upset when he lost to Gov. Kathleen Blanco. Now, I am very disappointed in his performance and would not vote for him again.

The first omen appeared when he opposed mandating the wearing of helmets by motorcyclists. Yet, helmets increase safety and reduce costs because of injury.

He opposed a bill to maintain a tax on cigarettes, the income of which was vital to some health programs.

He is so often out of the state on fundraising ventures that he should be paid only for the days he is in Louisiana working.

Recently, Jindal unwisely rejected federal Medicaid dollars that could have helped fund mental-health programs and aided the state hospitals budget. This folly ends up with Louisianians paying taxes that go to other state Medicaid programs, while we suffer for lack of funding.

Jindal is currently making massive cuts in the state hospital system. This will be destructive not only to medical care to the poor and uninsured, but will severely and permanently damage the training of physicians in Louisiana. Predictably, there will be devastating effects on LSU and Tulane Medical Schools to educate physicians.

With a reduction in hospital beds, and training programs for primary care and specialties, there will be a decrease in the number of new doctors who will establish practices in Louisiana, as most physicians practice in locations where they are trained. Too, the reduction of beds will cause many patients to go untreated or have the cost absorbed by private hospitals. Additionally, there will be a huge loss of jobs in health care, adding to the economic woes of our state. The Lallie Kemp Hospital in Independence is their only local source of jobs.

What is it about Jindal that he cannot comprehend this unfolding travesty? He appears obsessed with running for “higher office.” He apparently chooses to do or not do something depending on how it might affect his attractiveness to prominent Republicans, even though the choices hurt his people and his state.

What can be done to block what is going on in mental health care and the LSU State Hospital System? Unfortunately, we citizens have no real power other than to push for a recall or voice public opposition. He, however, has declared he does not care what his constituents think of him. State hospital administrators have been told to resign when they have opposed Jindal. LSU board members have been replaced. This is too much power.

The only hope is that the members of the state Legislature must rise up and oppose what is going on. They need to be challenged to protect us.

While you point to overwhelm as a factor there’s also the question of the quality of physicians coming out of the La. educational systems. It’s my opinion that in many cases one is better off seeing a veterinarian because many of the doctors I’ve seen are lucky to be able to find their own rear with both hands. Why? I was misdiagnosed consecutively by four private practice primary care physicians, all of whom never thought of a referral to a specialist and one specialist that thought the best initial way to examine the small intestine was with a colonoscopy, it being obvious that their major concerns were economic rather than the welfare of their patients. And I’m not talking about vague symptoms but signature symptoms found in no other illness. May a pox visit you all.

We will not recover from Jindal’s reign in my lifetime and this is just one example of why. That said, it also makes it abundantly clear why we need universal health care. Our present system is broken. The Affordable Care Act, despite making medical care available to more people, has not made the quality of that health care or the means of financing it better.

More of our citizens had more access to quality medical care under the state charity hospital system. It was something we should have taken pride in despite its imperfections. It showed we cared about people.

Health care, nationwide, is delivered with such inconsistency in quality and cost that going to a hospital is becoming more of a crap shoot than it ever was from both the morbidity/mortality and a cost viewpoints even for those who can ostensibly afford it.

John Kennedy is fond of providing us with anecdotes like grandma being baby sat in an emergency room at a cost of $2,000 to Medicaid while her children go out to dinner and a movie..I wonder how many anecdotes he would like to hear like the ones related here. Which do you think are more typical.

Jindal is a dishonorable man. Shame on any organizations that may hire him or book him as speaker. He should be shunned as the pariah that he is.

Also, shame on the enabler-Legislators. Face it, the modern-day Republican party is a force of evil. They are an enemy of the planet, an enemy of the middle class, an enemy of science, an enemy of peace, a friend of arms manufacturers, an implicit endorser of mass shootings, fomenters of shameless gridlock (for example, denying the president’s ability to fill much-needed federal judgeships. As this article shows, the Republicans are enemies of humane health-care. It is time for the Republican party to dissolve. It has had its run.

Reblogged this on Crazy Crawfish and commented:
Our general funding to DHH has almost trippled over the last 6 years in the wake of Bobby Jindal’s hospital privatization scheme that included the legislature approving a blank contract submitted by the Jindal administration. Tom Aswell and his sources relay some examples of what we bought for so much wasteful spending. More taxing and spending can not fix this problem, only make it worse. Someone needs to take some responsibility here. Expanding Medicaid, as Governor Edwards is pushing for, in this environment can only lead to more waste – and and very likely more death.

Executing blank contracts is certainly not a good business practice and is probably illegal under the state’s contract regs. See comments above on malfeasance. It’s past time to hold jindal and his puppets, and legislators, legally responsible for their illegal activities that have brought the state to it knees. The budget crisis was not a surprise, it was predicted a year or more ago.

If there ever is an investigation of illegal activity by Bobby Jindal, I expect it will not be initiated by the present attorney general and certainly with no pressure from the majority in the legislature. It will be up to the feds. I don’t know the law, but, as a citizen, I wonder how in haven’s name can signing a blank contract, in the name of the people of Louisiana, be legal.

Since federal funds are involved in some contracts and expenditures, perhaps the FBI’s public corruption unit would be a good place to start. But for state issues only, the Attorney General has a unit that investigates public corruption, and the EBR District Attorney has jurisdiction over events that take place in Baton Rouge. I believe the state constitution bars the attorney general from prosecuting most cases unless the local DA recuses him/herself. Someone correct me if that is not correct please. Also, the state Inspector General, who reports to the governor, is empowered to investigate any and everything in state government. Time to demand accountability.

You hear all kinds of rumors that the FBI is, or has looked at this. Nobody really knows because they never say and never will while the investigation is ongoing.

You are right about the AG, but remember the Attorney General is the state’s attorney,so he represents and defends the state, its agencies and officials.

I have wondered, for literally decades now, why, if fraud, waste, and abuse are so rampant in Louisiana, the Inspector General [whose office was created specifically to investigate them] has not rooted more of them out? Originally, he worked for the governor at his pleasure, but he has a statutory term of 6 years now and his dismissal by the governor must be approved by both houses of the legislature.

Why do we hear from the Inspector General so rarely? His biggest case in recent history was the Murphy Painter case and Murphy was exonerated of every charge. I think he is going to reveal some big secret whoop-de-do on Channel 9 tonight (which will fuel the no new revenue sentiment, no doubt), but what about all these other things we hear John Kennedy talk about?

If John Kennedy can, with authority and conviction, allege wrongdoing and give specific examples and give the public the impression hundreds of millions of dollars are being thrown away every year on these things, shouldn’t he give the Inspector General a call and report them? Now might be a good time since he has a new boss.

It doesn’t have to be this way. Follow the US Public Health Service model and have the equivalent Indian Health Service only for Louisiana’s poor.

The operation should nominally be run out of the National Guard under the direction of the state Surgeon General. The service pays for medical school tuition year for year, and a decent starting wage for primary care doctors. I count OB-Gyn and pediatrics as primary care.

The poor people get qualified and get their care at the clinics from doctors who do nothing but practice medicine all day. Referrals are by preexisting contract with the LPHS.
It would be way cheaper than what we have now, and could be paid for with a Medicaid waiver. Under O-care the state would have the right to add subsized people to the system and get bigger economies of scale.

I worked at Earl K Long for 32 years up until the last day and absolutely loved my job
I am fed up with the media (not you) and legislators (not all) bashing our healthcare delivery with absolutely no data to support it
They closed us with no data to support their argument that the privates could do it cheaper
When that didn’t prove to be factual now their argument is the service is so much better,again with no data
Before the committee meeting to close Huey P Long one of the legislators actually went there and visited with staff and patients and testified against the closure
What a novel idea- trying to get facts before voting
They need to read Five Days at Memorial by Sheri Fink
It is concerning Memorial and other New Orleans hospitals during and immediately after Katrina.
There is a section comparing what happened at the public hospital vs what happened at Memorial -p379-380
While many patients died at Memorial only 3 died at Charity and the author attributes it to the resourcefulness of the public employees
They didn’t wait on someone to rescue them.
They siphoned gas out of their cars to keep generators working
Public employees are purpose driven and are used to doing more with less so all through the years when our budgets were cut we never cut services
We did more with less
So we when hear legislators testifying about our rationing of care and patients dying while waiting to be seen we are justifiably upset.
I don’t know if they actually don’t know better or if it helps them to sleep at night fooling themselves into believing they did the right thing by going along with Jindal in dismantling a great health care system for the indigent as well as the best physician training available.
I am just very upset as are many of my colleagues to have our years of dedicated service discussed in such a derogatory manner.
It is bad enough that we all lost our jobs but to have our legacy tarnished is very hurtful.
Sorry I am so wordy but I just feel so strongly that Louisiana truly lost a lot when public hospital system was dismantled

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